How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,122 to $11,220Professionalmedian $1,778 · 10th to 90th $692 to $5,248
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $691.83 Median $3,090.30 Typical High $14,454.40 | Facility | None | $691.83 | $3,090.30 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $8,709.64 | Professional | None | $691.83 | $691.83 | $8,709.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $8,317.64 Typical High $11,481.54 | Facility | None | $5,011.87 | $8,317.64 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $2,511.89 Typical High $5,248.07 | Professional | None | $676.08 | $2,511.89 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $3,715.35 Typical High $7,762.47 | Professional | 50 · Both sides | $1,023.29 | $3,715.35 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $398.11 Typical High $831.76 | Professional | 80 · Assistant surgeon | $107.15 | $398.11 | $831.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $346.74 Typical High $724.44 | Professional | AS · PA/NP assist | $95.50 | $346.74 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $4,168.69 | Facility | None | $1,000.00 | $2,398.83 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $3,235.94 | Professional | None | $1,122.02 | $1,288.25 | $3,235.94 |
DeanCare Setting Facility Modifier None Typical Low $776.25 Median $3,162.28 Typical High $5,888.44 | Facility | None | $776.25 | $3,162.28 | $5,888.44 |
DeanCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,513.56 | $2,089.30 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,290.87 Typical High $3,090.30 | Professional | 50 · Both sides | $1,862.09 | $2,290.87 | $3,090.30 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $245.47 Typical High $331.13 | Professional | 80 · Assistant surgeon | $199.53 | $245.47 | $331.13 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $213.80 Typical High $288.40 | Professional | AS · PA/NP assist | $173.78 | $213.80 | $288.40 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $5,623.41 Typical High $10,964.78 | Facility | None | $912.01 | $5,623.41 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,905.46 Typical High $6,918.31 | Professional | None | $741.31 | $1,905.46 | $6,918.31 |
Network Health Setting Facility Modifier None Typical Low $2,691.53 Median $7,762.47 Typical High $9,120.11 | Facility | None | $2,691.53 | $7,762.47 | $9,120.11 |
Network Health Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $1,949.84 | Professional | None | $870.96 | $1,479.11 | $1,949.84 |
Prevea360 Setting Facility Modifier None Typical Low $691.83 Median $776.25 Typical High $1,445.44 | Facility | None | $691.83 | $776.25 | $1,445.44 |
Quartz Setting Professional Modifier None Typical Low $741.31 Median $1,698.24 Typical High $3,019.95 | Professional | None | $741.31 | $1,698.24 | $3,019.95 |
Quartz Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $4,570.88 | Facility | None | $724.44 | $2,754.23 | $4,570.88 |
Quartz Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $1,513.56 |
Security Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Security Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,090.30 Typical High $4,897.79 | Professional | None | $2,187.76 | $3,090.30 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $6,456.54 Typical High $11,481.54 | Facility | None | $1,318.26 | $6,456.54 | $11,481.54 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,513.56 Typical High $3,467.37 | Professional | None | $707.95 | $1,513.56 | $3,467.37 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $4,265.80 | Professional | 52 · Reduced service | $346.74 | $346.74 | $4,265.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $1,737.80 | Professional | 53 · Discontinued | $138.04 | $138.04 | $1,737.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $6,456.54 | Professional | 54 · Surgery only | $524.81 | $524.81 | $6,456.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $1,288.25 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $1,288.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $870.96 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $870.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $6,025.60 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $6,025.60 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $616.60 Median $758.58 Typical High $1,047.13 | Professional | 51 · Multiple procedures | $616.60 | $758.58 | $1,047.13 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,202.26 Typical High $1,659.59 | Professional | 54 · Surgery only | $977.24 | $1,202.26 | $1,659.59 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $302.00 Typical High $416.87 | Professional | 55 · Aftercare only | $245.47 | $302.00 | $416.87 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,288.25 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,288.25 | $1,737.80 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $199.53 Median $245.47 Typical High $331.13 | Professional | 81 · Minimal assistant surgeon | $199.53 | $245.47 | $331.13 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $199.53 Median $245.47 Typical High $331.13 | Professional | 82 · Assistant surgeon, no resident | $199.53 | $245.47 | $331.13 |
Where Wisconsin sits
The same service costs 16.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 2nd of 51
$2,399
AK $2,884TX $178
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.